Top Form Tuesday: Naturally Enhancing Fertility
1. Have sex, don't worry about exact position. You must have sex. New data says more sex is better and you have a 37% chance if you have sex every day when fertile, and only a 33% chance if you have sex every other day. Only home one day a week? those couples only have about a 15% chance of getting pregnant. All sex positions work for conception. Being in missionary position, having a pillow under your hips, and having orgasms have been talked about to lead to more often getting pregnant, but no medical studies back these pieces of advice up!
2. Enjoy your time cuddling or whatever you want to do after conception sex, no true evidence to the various exercises you need to put your hips through to encourage sperm to swim to their destination. Laying still after sex to enhance pregnancy also has not reliably been studied, but douching after intercourse does decrease your chance of conceiving.
3. Earlier is better, so have sex before you ovulate. The window for becoming pregnant is naturally about 5 days before ovulation and the day you actually ovulate. Your highest chance to conceive is to have sex just before ovulation. Ovulation occurs on day 13 or 14 for women with a 28 day cycle. Thus women who ovulate on day 14 will have their best for pregnancy sex on day 12 and 13.The fertile window is the 6 days ending on the day of ovulation as the egg may not be able to survive more than a few hours and sperm can survive for about 6 days. Worrying about his sperm count if you have sex too often? This is probably not a problem, and even if sperm counts do go up if he hasn't had sex for 2 days, over 10 days and his sperm count will lag.
4. Trying for a boy? Boy sperm do swim faster. Having sex close to ovulation statistically helps to have a boy, but only by a very few %. For having a girl, try to have sex two to three days prior to ovulating.There is virtually no data to say that oils are harmful. Didn't get to the store for lubricant? Mineral Oil and canola oil work just as well.
5. The best vitamins for conceiving have proper folic acid and also have omega-3 nutrients. Do ask regarding the use of shakes, supplements or specialized vitamins as they may contain ingredients that have not been tested for safety during pregnancy.
6. Be nutritionally healthy. High cholesterol means low fertility. And if you and he both have high cholesterol your fertility will even be worse. The best type of diet is a basic healthy diet that conforms to the My Plate diet. Beyond that there are some dietary restrictions that we would like to discuss with our patients. Examples of foods to avoid: do not eat undercooked meat as it could carry some risk of toxoplasmosis. And too many portions of fish per week can increase the risk of mercury.
7. Do not over exercise, but no time to slack off either. Continue your exercise routine, if you are not exercising then a specific plan to begin and increase exercise should be discussed with your physician. In a recent study of physical activity of infertility patients it was found that too much activity actually reduced the success of fertility treatments, but too little activity decreased success as well.
8. You are fertile, at least you are likely to be. And it shouldn't take too long. The newest statistics say that 80% of couples will achieve pregnancy after trying for 6 months, and about 85% after trying for 12 months. If you keep trying another 3 years another 8% will get pregnant. American Women have a 89% chance of being fertile according to the recent CDC statistics. This however will vary by age and you are 50% less fertile in your late 30s as you were in your early 20s. There are no specific tests of fertility the average healthy woman would need to perform. The March of Dimes has pregnancy planning information as well. It is good to have normal laboratory work, and there are some global efforts to have healthier pregnancies that you may be interested in.
9. Be a comfortable temperature in bed. You can use your electric blanket still. There is no evidence that any low level magnetic fields: from computers, microwaves or electric blankets are harmful or produce birth defects
10. Limit caffeine intake to under 200 mg per day, this has been shown to help reduce the rate of miscarriage and improve overall fetal growth.
11. Being a healthy weight before conceiving increases fertility and decreases your chances of miscarriage. If you have enough time to diet off to a healthy weight this is ok, but a better way to fertility weight loss is to normalize your BMI (at least under 30) with exercise if possible. When fertility patients were studied in Denmark moderate levels of exercise in the group was much more likely to get pregnant regardless of a woman's overall weight, whether she is obese or whether she has a high BMI.
12. Select a well balanced diet. No specific diet has been shown to make you more fertile, nor is there any data to say fertility supplements work any better than a healthy diet. Caffeine is acceptable in moderation, and high levels will be associated with increased risks of miscarriage.
14. Continue to take all your routine medications, but see your physician to decide if these medications need to be changed when planning pregnancy or when early pregnant. Stopping medications on your own is not healthy.
15. Plan your pregnancy, see your physician to discuss any genetic testing that may be important. Genetic testing for over 100 diseases is currently available, it is not a necessary step on a routine basis, but only something you should have with individual consultation with your health care provider.
16. Moderate all alcohol consumption, and consult your physician regarding any alcohol consumption once you have a positive pregnancy test.Although there was one study saying that alcohol consumption in women, in moderation, increases fertility, most physicians would not recommend this as a fertility strategy.
17. Women return to fertility very rapidly after stopping contraceptive pills, although there is no harm in attempting pregnancy right away some physicians recommend holding off for two cycles to allow resumption of normal ovulation.
18. Stop smoking, both of you! Smoking is a known cause of infertility, it increases miscarriage risk and you are more likely to enter menopause early. Pregnancies in women who smoke are also more likely to have small babies.
19. Eliminate exposure to environmental toxins which include pesticides, and solvents. Check at your work place if you are exposed to chemicals there and find out if they have known harmful effects in pregnancy.
20. Specific medical testing for women planning pregnancy is covered in this publication: Johnson K, Posner SF, Biermann J, et al. Recommendations to improve preconception health and health care -- United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. CDC. MMWR Recomm Rep. 2006;55(RR-6):1-23